Are You Still Taking Oral Contraceptives?

Can you be too old to take birth control pills?

At what age should a woman stop taking birth control?  This million dollar question is for the woman who dares to stop taking birth control even if she is near menopause or menopausal.   Fear of unintended pregnancies and menopausal symptoms keep women on oral contraception.  Some women believe taking birth control pills will ease them into menopause, there are no studies to prove that philosophy.

Menopause marks the end of a woman’s reproductive ability and you can’t get pregnant. Many women go through a period of irregular bleeding before they become menopausal and this is a common reason some health providers will start oral contraception for a premenopausal woman.

Traditional oral contraception is not the same as hormone replacement therapy used to treat premenopausal and menopausal women.  The amount of hormones in an oral contraception pill is much higher than the hormones found in hormone replacement therapy for the treatment of menopausal and premenopausal symptoms.   And it is not the same hormones.  The higher dosage is needed in contraception because the goal is the suppress ovulation which leads to the prevention of pregnancy.  All birth control pills use synthetic hormones.

A woman can no longer get pregnant if she is no longer ovulating.   With menopause comes the suppression of ovulation.  How do you know if you are menopausal or not is a question that a lot of women ask once they reach a certain age.  The answer is it’s based on your menstrual cycle.  The average age of menopause is 51 plus or minus three years.  By definition a woman is considered menopausal if she has not had a period in 1 year.  You may notices signs of your weaning hormones if you develop vasomotor symptoms like (hot flashes).

A clinical lab FSH (Follicle Stimulating Hormone), could be tested to see if it is in menopausal range.  This would be a clinical indicator that you are indeed menopausal.

There are three reasons why I would not recommend continuing birth control pills for menopausal symptoms.

  1. The older you are and on oral contraception your risk of developing a DVT (Deep venous Thrombosis) increases particularly if you are a smoker.  A DVT can be fatal if the clot goes to your lungs.
  2. The synthetic hormones found in oral contraception will not treat common symptoms that menopause and premenopausal women complain of such as insomnia, hot flashes and night sweats, decreased libido and weight gain.
  3. Oral contraception is to prevent pregnancy and you can’t get pregnant when you are truly menopausal.

Considering the above pregnancy is far more risky than taking contraception for the older woman.  A woman who gets pregnant after the age of 35 is considered a high risk patient and given the diagnosis of Advanced Maternal Age.   For some patients a low dose birth control may be indicated.

Hormonal management is used for things other than ovulation suppression.  Common gynecologic issues treated with contraception include heavy menstrual bleeding, mood swings, acne, painful periods, endometriosis and PMS.  For the menopausal woman suffering any of these symptoms you should see your gynecologist to find out the underlying cause and if you could be treated with something other than oral contraception.

Bleeding in a menopausal woman is called post-menopausal bleeding.  Post-menopausal bleeding should never be taken for granted.  It could be a sign that a precancerous lesion is inside the uterus.  If this goes untreated it can progress to endometrial cancer.  Endometrial cancer is the most common gynecological cancer in women and usually treated with surgical correction unlike ovarian and cervical cancer that may require chemotherapy or radiation along with surgery.

As a woman ages certain medical conditions occur more often.  These include cancer, osteoporosis, coronary artery disease, diabetes mellitus, pulmonary disorders, Alzheimer disease and adult macular degeneration.  Many of these conditions are associated with aging and lower estrogen levels after menopause.

Lifestyle changes such as improvements in diet and exercise may benefit your overall health during menopause as well as the right combination of hormone replacement therapy.

 

 

 

 

 

 

 

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